HSC hosts conference to address urban health care, inequities

By Michael Haederle |
March 07, 2014

The themes of community engagement and measuring population-wide health improvements – major priorities for the University of New Mexico Health Sciences Center – took center stage at a two-day conference focused on urban healthcare.

UNM hosted some two dozen researchers from SUNY Downstate, the University of Cincinnati, Cleveland State University/Northeast Ohio Medical University (NEOMED) and the University of Missouri – Kansas City for the March 3-4 Urban Universities for HEALTH (UU Health) conference.

UU HEALTH, a collaboration between the Association of American Medical Colleges (AAMC), the Association of Public and Land-grant Universities and the Coalition of Urban Serving Universities is funded by a grant from the NIH National Institute on Minority Health and Health Disparities.

The initiative seeks to build a diverse healthcare workforce to serve city-dwellers while addressing health inequities. Much of the discussion focused on ways of identifying and overcoming barriers that prevent more people from underrepresented communities from pursuing health careers.

“We have two major objectives,” said Marc Nivet, a co-principal investigator for the project and chief diversity officer for AAMC. “One is learning – that learning occurs. This is bi-directional learning. All of your institutions are here for a reason. Our job is to capture that knowledge, and more importantly, to disseminate that knowledge.

“The other measure is, ‘Did you have fun when we were together?’”

In that vein, the group visited Albuquerque’s Martineztown neighborhood, where a close-knit community association has long supported the local school, Longfellow Elementary. They heard presentations from community leader Frank Martinez and school principal Richard Ulibarri, toured public art installations and visited Manuel’s Food Market, a 90-year-old store that serves as a neighborhood gathering place.

Conference participants said they were impressed by UNM’s efforts to address health disparities, which range from the BA/MD program that guides high school students from rural New Mexico communities into medical careers, to the Health Extension Rural Officers and community health workers who leverage medical and nursing resources throughout the state.

“It’s pretty clear, based on what we saw here in New Mexico, that we need to have better ways of accounting for our relationships within the community,” said Aaron Bonham, a UMKC senior statistician.

Eric Porfeli, an assistant dean at NEOMED, pointed out that UNM’s community outreach efforts also represent a rich research opportunity. “I was struck by the fact that UNM has an immense and extensive network,” he said. “There ‘s a mountain of data you could collect on any one of the things they’re doing.”

In welcoming remarks, Dr. Paul Roth, UNM’s chancellor for health sciences and dean of the School of Medicine, described how his institution developed its signature Vision 2020, which promises that New Mexico will make more progress in health and health equity than any other state by the end of the decade. The process started, he said, when he took over as HSC head in 2006 and created an Office of Community Health, headed by Dr. Arthur Kaufman.

“I knew there was more that our academic health center could provide the state of New Mexico than what we had conventionally done,” Roth said. “It seemed to me there could be synergies between research, education and patient care that was greater than just the sum of those parts.”

Kaufman led a bus trip around New Mexico to gauge community health needs. The UNM team got a surprise when they met with Native American leaders, Roth said. Their No. 1 concern turned out to be oral health.

“They could show that kids lost more time from school because of dental problems,” Roth said. “They had pain, and they just didn’t show up. That was out of the blue. None of us anticipated that.” Because of that insight, UNM now has a department of dental medicine, he added.

Dr. Richard Larson, executive vice chancellor and vice chancellor for research, told the group how the New Mexico Legislature had given the HSC the responsibility for collecting and analyzing health workforce data.

It’s a formidable task, because the information provided to professional licensing boards does not accurately represent where healthcare workers actually practice, Larson said.

“In New Mexico there’s a substantial number of health care workers who are licensed here but do not practice here,” he said. “About 25 percent of our health care professionals are licensed in New Mexico but don’t actually practice here.”

The state has major shortages of primary care providers in nursing and medicine, particularly in rural areas, Larson said. There’s a need to train community health workers to help meet some of those deficiencies, he added.

Larson also identified a structural problem in physician education, where the number of federally funded residency slots is not increasing, even as medical schools graduate more students. The HSC has addressed this problem by asking the Legislature for money to fund additional residencies, he said.

The deans of the School of Medicine, College of Nursing and College of Pharmacy also discussed the challenges their programs had in meeting diversity goals. Nancy Ridenour, dean of the College of Nursing, spoke of the need to improve the diversity of the student body.

“We want to more closely approximate the population,” she said. “We have to start the undergraduate level to increase the number of diverse students and put them on track toward graduate school.”

Diversity is a priority at the College of Pharmacy, dean Lynda Welage said, but there is a pressing need to boost the percentage of Native Americans in the student body.

In the School of Medicine, “The students are significantly more diverse than the faculty,” said Dr. Thomas Williams, executive vice dean. “About 25 percent are Hispanics. The faculty is significantly less diverse.”

The conference included a number of interactive exercises, including a “shark tank” competition in which each school presented a proposal for up to $15,000 to fund a pilot project that would promote diversity in the healthcare workforce.

Ideas included training high school students as community health advocates, waiving college application fees for financially underprivileged students and using social media and websites to encourage students in minority communities to pursue health careers.

Kaufman led a presentation on the One Hope Centro La Vida Clinic in Albuquerque’s Southeast Heights neighborhood. The faith-based program is staffed by dedicated volunteers from UNM’s nursing, pharmacy and medical faculty and student body. “This is a clinic to beat the band,” he said.

Clinic director Lidia Regino described how her staff members – all of whom are trained as community health workers – often elicit pertinent health information from patients, many of whom are undocumented immigrants who are not proficient in English. “We end up catching a lot of issues that the doctors missed,” she said.

Family medicine resident Dr. Tatiana Guerrero added that volunteering at the clinic keeps her on her toes. Although staffing the clinic means spending additional time away from her family, “You just make the time,” she said. “It’s that rewarding.”